Individual provider Active NPI

Earl Akio Hasegawa, D.D.S., M.S.

  • Oral and Maxillofacial Surgery (Dentist)
  • Kahului, HI
National Provider Identifier
1114071107
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
DT-1657 Issued in HI
Practice address
135 S Wakea Ave Ste 103
Kahului, HI 96732-1385
Phone
(808) 877-7775
Fax
(808) 877-4058
NPI assigned
Jan 23, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X DT-1657 HI Primary

Addresses

Primary practice location

135 S Wakea Ave Ste 103
Kahului, HI 96732-1385

Mailing address

135 S Wakea Ave Ste 103
Kahului, HI 96732-1385
Phone (808) 877-7775

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Oct 23, 2015 through Oct 23, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
DT-1657HIMDOral and Maxillofacial Surgery (Dentist)

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114071107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 S WAKEA AVE STE 103",
            "city": "KAHULUI",
            "state": "HI",
            "postal_code": "967321385",
            "telephone_number": "808-877-7775",
            "fax_number": "808-877-4058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 S WAKEA AVE STE 103",
            "city": "KAHULUI",
            "state": "HI",
            "postal_code": "967321385",
            "telephone_number": "808-877-7775",
            "fax_number": "808-877-4058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HASEGAWA",
        "first_name": "EARL",
        "middle_name": "AKIO",
        "name_prefix": "Dr.",
        "credential": "D.D.S., M.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "HI",
            "license": "DT-1657",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kahului, HI

Sources for this page

Verify at the official NPI Registry.